Patient Access Representative

Position Summary

The Patient Access Rep creates accurate and thorough registration for admissions, pretest, and outpatient registrations. Secures appropriate signatures, financial information, point of service collections, and documents for treatment and billing purposes. The Patient Access Rep interacts in a customer focused and compassionate manner to ensure patients and their representatives’ needs are met, and that they understand the hospital’s policies as they relate to professional, efficient, and quality customer services.

Department Summary

Admitting and Outpatient Registration areas are located off the Main lobby, often dealing with patients/ clinical staff face to face or over the phone, entering and verifying patient demographic information- patient’s name, DOB, address, phone number, race, ethnicity, language, marital status, religion, church, diagnosis, physician, guarantor billing, insurance, collections and emergency contacts.

Qualifications

• High School Diploma or equivalent
• Previous clerical or customer service experience preferred (class work may be substituted for previous work experience).

Department Qualifications

• Prefer minimally one-year experience in a hospital, medical office/clinic, or insurance company.
• Prefer medical terminology certification.

Skills

• Ability to perform a variety of tasks, often changing assignments on short notice.
• Must be adept to multi-taking and prioritization.
• Will be required to learn and work with multiple software/ hardware products during an average workday.
• Must possess excellent verbal and listening communication skills.
• Must be able to maintain a professional demeanor in stressful situations.
• Must be adept with equipment typically found in a business office environment- fax, copier, printer, scanner.
• Ability to build productive relationships with all contacts.
• Typing skills of 35 words per minute minimum.
• Must have good computer skills with the ability to work out of multiple systems in tandem, on dual monitors.

Department Skills

• Ensure patient tracking systems are updated with patient activity.
• Answers phones and routes call as necessary.
• Monitors and maintains multiple work queues as instructed and assigned.

Responsibilities & Expectations

• Demonstrates compliance with all policies related to the organization’s Corporate Compliance Program as evidenced by attendance at applicable educational programs; consistently carrying out job responsibilities ethically and professionally; exhibiting ethical and professional workplace behavior and decision making and reporting any infractions using the appropriate chain of command and without fear of retribution.
• Completes annual learning requirements, reviewing fire safety and electrical safety policies, applicable code reviews, disaster plans reviews, policies on handling hazardous and toxic substances and risk management issues.
• Demonstrates an interest in patient safety education and participates proactively in indetifying problems and incidents in the department and throughout the hospital which place any patient, visitor, or staff member at risk or injury.
• Attends educational seminars, meetings and updates as needed.
• Modifies work schedule to meet department goals and deadlines.
• Follows EMTALA, HIPAA, payer, and other regulations and standards.
• Maintain work area in neat and orderly fashion.
• Observes hospital and department guidelines concerning dress and display of name badge, presenting an appearance appropriate to work environment.
• Adheres to department customer service standards.
• Avoids excessive absenteeism and tardiness so that it does not warrant repeated disciplinary action and disrupt department productivity.
• Adheres to established schedule for break and meal periods.
• Willingness to assist department needs with staffing and tasks.

Department Responsibilities & Expectations

• General
  • Accurately and thoroughly collects, analyzes, and records demographic, insurance, financial and clinical data in computer systems.
  • Updates and edits information in computer systems, ensuring that all fields are populated correctly and appropriately.
  • Obtains information and completes a Medicare Secondary Payer Questionnaire and other payer specific documents.
  • Reviews and explains all registration forms prior to obtaining signatures from patients or appropriate representatives.
  • Records patient email address when available for patient portal enrollment and applicable surveys.
  • Documents System with activity comments to ensure appropriate account follow-up.
• Outpatient
  • Ensures Provider order is accurate and meets hospital guidelines.
  • Performs compliance checking of order for Medicare Insurance.
  • Contacts Physician’s offices for clarity on orders.
  • Captures correct Primary Care physician.
  • Maintains standing orders for patients with repeat services.
  • Prepare folders for upcoming pre-test patients.
  • Take Private Pay Agreement payments via PersonaPay.
  • Point of Service Collections. Including CoPay, CoInsurance, Deductible, and estimated liabilities.
  • Must be able to identify Out of Network insurances and turn patients away if need be.
  • Services as ALS registration back up during peak workloads.
• Admitting
  • Services Admissions processes for ALL Facilities- Aultman Canton, Aultman Massillon ER, Woodlawn, Aultman Orrville and Aultman Alliance Community Hospital.
  • Monitors Bed Management system for any admissions.
  • Provides Wristbands, letters or forms to clinical units.
  • Reviews and enters admission orders for accurate time and status of care.
  • Escorts patients to room and performs “hand off” process with clinical staff.
  • Performs Census balance of all beds and units at all facilities.
  • Ensures bed assignments for appropriate room and board charging.
  • Provides assistance to patients and family members for Medical Record updates and questions.
  • Identifies Duplicate Medical records for all Facilities.
  • Insurance Follow up to ensure correct insurance.
  • Travels to patient rooms to capture and records IMM (Important Medicare Message) per compliance requirements.
  • Services as ALS registration back up during peak workloads.
  • Serves as Outpatient registration back up when staffing is short.

Working Conditions

• Coordinated lunch and break periods.
• Continual involvement with patients and their families.
• Ability to assist patients in wheelchairs and transport if necessary.
• Assigned uniform to be worn at all times.
• Outpatient
  • Open 6a-5p M-F
  • Every 3rd Sat 7a-3:30p
  • No holidays
• Admitting
  • 24/7
  • Every other weekend and holiday

Hazardous Exposure Category

Category III - Includes tasks that involve no exposure to blood, body fluids, or tissues and Category I tasks are not a condition of employment. The normal work routine involves no exposure to blood; body fluids or tissues (although situations can be imagined or hypothesized under which anyone anywhere might encounter potential exposure to body fluids.) Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency care or first aid or to be potentially exposed in some other way.

Physical Addendum

Demands

Frequency

Remarks

Lifting 0-10 lbs

Continuous 66% of the day

Lifting 10-20 lbs

Continuous 66% of the day

Lifting 20-35 lbs

Occasional 10-33%

Lifting 35-50 lbs

Occasional 10-33%

Lifting 50-75 lbs

Occasional 10-33%

Lifting 75-100 lbs

Occasional 10-33%

Lifting over 100 lbs

Occasional 10-33%

Forward Reaching

Frequent 34-65%

Overhead Reaching

Frequent 34-65%

Standing

Frequent 34-65%

Walking

Frequent 34-65%

Sitting

Frequent 34-65%

Climbing

Frequent 34-65%

Stairs/Ladder

Occasional 10-33%

Bending/Stooping

Frequent 34-65%

Twisting/Turning

Frequent 34-65%

Kneeling/Squatting

Occasional 10-33%

Crawling

Never

Pushing/Pulling 0-10 lbs

Frequent 34-65%

Pushing/Pulling 10-20 lbs

Frequent 34-65%

Pushing/Pulling 20-35 lbs

Occasional 10-33%

Pushing/Pulling 35-50 lbs

Occasional 10-33%

Pushing/Pulling 50-100 lbs

Occasional 10-33%

Pushing/Pulling over 100 lbs

Occasional 10-33%

Carrying 0-10 lbs

Occasional 10-33%

Carrying 10-20 lbs

Occasional 10-33%

Carrying 20-35 lbs

Occasional 10-33%

Carrying 35-50 lbs

Never

Carrying 50-100 lbs

Never

Carrying over 100 lbs

Never

Grasping/repetitive sustained

Frequent 34-65%

Fine motor coordination

Frequent 34-65%

Vision: Near/Far/Color

Continuous 66% of the day

Hearing: ordinary conversation/other

Continuous 66% of the day

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender identity, sexual orientation or protected veteran status. The organization is an EEO/AA Employer Disability/Vet.

The organization will provide reasonable accommodations to employees or applicants with disabilities, as defined by the Americans with Disabilities Act, who are otherwise qualified to safely perform the essential functions of the job, with or without accommodation, unless such accommodation would constitute an undue hardship on the organization or poses a direct threat to the health and safety of the individual or others that cannot be sufficiently mitigated by reasonable accommodation. Any applicant or employee who requires an accommodation to perform the essential functions of his or her job or to enjoy equal benefits and privileges of employment should notify the Aultman Human Resource Department and request such an accommodation.